What Is The Small Cities Initiative?
The focus of the Small Cities Initiative is developing the first municipally led, integrated standards for prevention, treatment, harm reduction, recovery, policing services, and policies and strategies, in a resource we call the “playbook.”
Thirty regions from coast to coast to coast have now significantly contributed to the playbook, launching this November at our Issues of Substance conference.
The “Initiative” encompasses the Timmins Summit, winter webinars and Municipal Leaders Table. It will also include our summer webinar series before the playbook launch.
How will this help?
The playbook will provide municipal leaders with a consolidated range of evidence-based options they can choose from, based on their regional realities. It will help unlock vital government support, as well as reduce the growing polarization concerning this crisis.
To date, regions represented in the Small Cities Initiative include: Brantford, Brockville, Burlington, Cambridge, Campbell River, Charlottetown, Cobourg, Cornwall, Duncan City, Fredericton, Kensington, Lethbridge, Miramichi, New Westminster, North Battleford, North Cowichan, Northwest Territories, Orangeville, Penticton, Portage la Prairie, Powell River, Prince Albert, Prince County, Prince George, Queens, Red Deer, Stephenville, Thompson, Timmins and West Nipissing.
The Initiative has multiple phases:
• Municipal Leaders Table — in Lethbridge, AB, April 2025
• Winter Virtual Sessions — February and March 2025
• Timmins Summit — in Timmins, ON, September 2024
Coming up:
• Summer webinar series — exploring substance use health topics and introducing newcomers to the Initiative
• Playbook launch — at our Issues of Substance conference, November 2025
Municipalities that are interested in the project or would like to be kept informed on its development can contact us. Over the summer months, we will work to support communities through community engagement, training and education.
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Read All About It
Elected officials and community leaders came from coast to coast to coast. Senator Sharon Burey, who is known for her work in children’s mental health, equity and social justice, delivered the keynote address.
Attendees reviewed a variety of interventions, from health care and education, to bylaws, community safety measures, prevention and workplace programs. They were also asked to develop a table of contents for what they would need to make the playbook resource as practical as possible.

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News Release

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Global
Canadian municipalities discuss opioid solutions in Lethbridge.

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CTV
Mayors from across Canada gather in Lethbridge for conference on opioid issues.

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CBC Homestretch
Opioid conference in Lethbridge.

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Calgary Herald
Canada’s small cities and towns facing same toxic drug issues as big cities.

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Bridge City News
Mayors gather at Lethbridge to discuss opioid crisis.

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Lethbridge News Now
Canadian mayors collaborating on opioid crisis strategies in Lethbridge.

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Our Media Compilation
Later this spring, Timmins Mayor Michelle Boileau will engage additional mayors from across Canada and brief them on the initiative and playbook during the Federation of Canadian Municipalities’ Annual Conference and Trade Show in Ottawa, Ont.
Open substance use in public spaces, rising numbers of substance use–related hospitalizations and deaths, and a lack of affordable and stable housing are only a few of the challenges small cities face as they attempt to better serve the needs of their communities.
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The substance use crisis is not just a big city issue...
Winter Virtual Sessions
In February 2025 we hosted a virtual event as an introduction to this work. We were joined by mayors and city representatives from all across Canada: Our co-chair cities Lethbridge and Timmins, plus Brantford, Cambridge, Charlottetown, Duncan, Fredericton, Portage La Prairie, Prince George, Queens, Red Deer, Stephenville, Thompson and West Nipissing.
That group was joined by several new cities for our March 2025 virtual event: Brockville, Burlington, Campbell River, Cobourg, Cornwall, Kensington, Miramichi, New Westminster, North Cowichan, Orangeville, Penticton, Powell River, Prince Albert and Prince County.
These virtual sessions were leading up to the in-person Municipal Leaders Table.
Read Harnessing the Power of Community to Tackle the Toxic Drug Crisis for more insight into this initiative from our CEO Dr. Alexander Caudarella.
Continue reading to learn how this work began, with the Timmins Summit in September 2024.
Timmins Summit
We co-hosted a special event with the City of Timmins to examine the impact of the substance use crisis on small-sized cities across Canada. In a first-of-its-kind initiative, the Timmins Summit brought together elected leaders, public health officials, drug policy experts, local service providers, resource industry leaders and people with lived and living experience.
Summary Report
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Timmins Summit Summary Report
We are thrilled to share our summary report that reflects what was discussed by the 70 community leaders who attended. Here is a high-level overview:
- The substance use crisis has evolved into a major public health issue, especially in smaller communities that frequently lack the authority and funding needed to address it effectively.
- Addressing the issue is difficult due to a lack of local resources, burnout and staff shortages among service providers, stigma and public perception of substance use, the housing crisis, public drug use, a fragmented system of care and diverse regional challenges.
- Indigenous communities, youth, people who are 2SLGBTQ+ and people recently released from incarceration are disproportionately impacted.

Read All About It

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Our media advisory

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CBC Sudbury
Conference in Timmins aims to find solutions to opioid crisis in smaller Canadian cities and towns.

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Timmins Daily Press
Civic leaders descend on Timmins for national substance use crisis summit.

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CTV Calgary
Lethbridge looking for new strategies to address substance abuse.

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North Bay Now
West Nipissing represented in national discussions on substance use.

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Bridge City News
Lethbridge Mayor speaks after substance use summit.

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Our press release
Latest CCSA Updates

Mayors from across Canada gather to identify solutions to local substance use crises
Ottawa, May 1, 2025 — Mayors and city representatives from across Canada gathered in Lethbridge, Alta., April 14–16, 2025, to review approaches for addressing the substance use…
Ottawa, May 1, 2025 — Mayors and city representatives from across Canada gathered in Lethbridge, Alta., April 14–16, 2025, to review approaches for addressing the substance use…
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Guidance, Tools and Resources
CCSA produces research-based publications, tools, and resources to support evidence-based decision-making on substance use health issues. Select your area of interest from the categories below to learn more:
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Substances
CCSA produces a variety of substance use- and addiction-related publications for researchers, policy makers and health service providers. We provide guidance to decision makers through harnessing the power of research, collecting and organizing knowledge, and bringing together diverse perspectives.
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Health and Public Safety
CCSA conducts research, develops tools and resources, and produces targeted materials to support evidence-based decisions and public policy. Review our key resources on health and public safety in relation to substance use health and addiction issues.
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People and Communities
CCSA is dedicated to the health and well-being of individuals and communities, focusing on the impact of substance use across the lifespan, the perspectives of people with lived experience, and the roles of stigma, sex and gender, and educators in substance use health.